Dupuytren’s fasciectomy is a surgical treatment for Dupuytren’s disease. It is often recommended when Dupuytren’s disease has progressed to an advanced stage, known as Dupuytren’s contracture.
What is Dupuytren’s disease?
Dupuytren's disease causes the connective tissue just below the skin in your palm and fingers, known as fascia, to thicken and become scar-like.
Over time this tissue may start to contract and pull one or more of your fingers towards your palm and prevent them from being straightened anymore. This permanent curling of one or more fingers into your palm is known as Dupuytren’s contracture.
When do you need treatment for Dupuytren’s disease?
Dupuytren’s disease affects people differently. If you have a mild case of it then it may not progress and treatment may not be necessary.
If you're unable to fully extend one or more of your fingers it’s advisable to see your GP or a specialist hand surgeon who will examine your palm and hand. They will measure the amount of deformity to determine the severity of your condition. Your GP may refer you to a consultant hand surgeon for further assessment and treatment as required.
If your contracture has developed so that it significantly affects your hand function and you struggle to flatten your hand on a table top then treatment will be advised.
Treatment options for Dupuytren’s contracture
Treatment will be based on the severity of your Dupuytren’s contracture.
Dupuytren’s fasciectomy surgery is the most common treatment of Dupuytren's contracture. This surgical option is usually considered if your fingers are already bent by more than 15 to 20 degrees and you have restricted use of your hand.
Alternative treatments include radiation and needle aponeurotomy.
Several doses of radiotherapy may slow down or stop the disease as it irradiates the nodules and cords associated with Dupuytren’s. However, there are side effects of radiation, such as dry and flaking skin and skin thinning. Needle aponeurotomy, also known as needle fasciotomy, is an outpatient procedure that involves using a very fine needle to sever and divide the fibrous tissue in your hand. Often, however the symptoms return and a repeat procedure is then needed.
What does Dupuytren’s fasciectomy surgery involve?
Dupuytren's fasciectomy is a surgical procedure that removes the thickened tissue in your palm to treat Dupuytren’s contracture.
The operation can be performed to different degrees depending on your needs. It can range from cutting the fibrous band in the palm of your hand to moving all of the scarred skin and replacing it with skin grafts. It can be done under local, regional or general anaesthetic.
What are the benefits of Dupuytren’s fasciectomy?
Dupuytren’s fasciectomy can help improve your hand function if you have Dupuytren’s contracture and it can allow you to straighten the affected fingers more.
What are the complications of Dupuytren’s fasciectomy?
As with any surgical procedure, there may be complications. General complications of surgery include: pain, bleeding, wound infection and scarring.
Specific complications of Dupuytren’s fasciectomy surgery could include:
- Injury to an artery or nerve in your finger
- Return of Dupuytren’s disease
- Finger joint stiffness
- Wound healing problems
- Complex regional pain syndrome – where your hand becomes stiff, painful and swollen. However it often resolves within a few months.
How long will recovery be after Dupuytren’s fasciectomy surgery?
You should be able to go home the same day as your surgery. Your hand may feel sore and swollen initially but this should settle within a few weeks.
You may be advised to do some exercises to help you resume normal activities.